Vascular Calcification: Pathophysiology and Risk Factors

Abstract

Vascular calcification can occur in nearly all arterial beds and in both the medial and intimal layers. The initiating factors and clinical consequences depend on the underlying disease state and location of the calcification. The best studied manifestation is coronary artery calcification, in part because of the obvious clinical consequences, but also because of CT-based imaging modalities. In the general population, the presence of coronary artery calcification increases cardiovascular risk above that predicted by traditional Framingham risk factors, suggesting the presence of nontraditional risk factors. In patients with chronic kidney disease (CKD), coronary artery calcification is more prevalent and markedly more severe than in the general population. In these CKD patients, nontraditional risk factors such as oxidative stress, advanced glycation end products, and disordered mineral metabolism are also more prevalent and more severe and offer mechanistic insight into the pathogenesis of vascular calcification.

Notes

Disclosure

Dr. Chen has received grant support from Genzyme Corp. and has received royalties from Amgen.

Dr. Moe has served as a consultant for and received honoraria from Genzyme Corp., Shire, Amgen, and Citrolink; has been paid for providing expert testimony by Fitzpatrick; has received grant support from Genzyme Corp., Shire, and Amgen; holds stock/stock options in Eli Lilly and Company; and has had travel/accommodations expenses covered/reimbursed by Shire, Genzyme Corp., and Amgen.

References

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